Combined effects of family history of CVD and heart rate on ischemic stroke incidence among Inner Mongolians in China

Abstract

Objective: This study aimed to evaluate the combined effects of family history of cardiovascular diseases (FHCVD) and heart rate on ischemic stroke incidence among Inner Mongolians in China.

Methods: A prospective cohort study was conducted among 2589 participants aged 20 years and older from Inner Mongolia, China. The participants were divided into four groups according to status of FHCVD and heart rate and followed up from June 2002 to July 2012. Cox proportional hazards models were used to evaluate the combined effects of FHCVD and heart rate on the incidence of ischemic stroke.

Results: A total of 76 ischemic stroke occurred during the follow-up period. The observed ischemic stroke cases tended to be older and male, and had higher prevalence of smoking, drinking, hypertension and FHCVD as well as higher systolic and diastolic blood pressures at baseline compared with those who did not experience ischemic stroke. Age- and gender-adjusted hazard ratio (95% confidence interval) of ischemic stroke in the participants with both FHCVD and heart rate ≥ 80 were 2.89 (1.51–5.53), compared with those without FHCVD and heart rate < 80. After multiple adjustment, the association between ischemic stroke risk and both FHCVD and heart rate ≥ 80 remained statistically significant (hazard ratio, 2.47; 95% confidence interval: 1.22–5.01).

Discussion: Our main finding that participants with both FHCVD and faster heart rate have the highest risk of ischemic stroke suggests that faster heart rate may increase the risk of ischemic stroke among people with FHCVD.

Keywords:

• Family history of CVD
• Heart rate
• Ischemic stroke

Acknowledgements

We thank the study participants, the Kezuohou Banner Center for Disease Prevention and Control and the Naiman Banner Center for Disease Prevention and Control for their support and assistance.

Notes on contributors

Yipeng Zhou is a postgraduate student at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. His research interests include epidemiology and cardiovascular disease.

Yunfan Tian is a postgraduate student at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Her research interests include epidemiology and cardiovascular disease.

Chongke Zhong is a doctoral student at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. His research interests include epidemiology, biomarkers and cardiovascular disease. His recent publications appear in Atherosclerosis, Molecular Neurobiology and Hypertension Research.

Buren Batu is a senior researcher at the Department of Epidemiology, Tongliao Center for Disease Prevention and Control, Tongliao, China. His research interests include epidemiology, prevention for hypertension and cardiovascular disease.

Tian Xu is a doctor of epidemiology at the Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China. His research interests include epidemiology, neurology and cardiovascular disease. His recent publications appear in Stroke, Journal of Hypertension and International Journal of Cardiology.

Hongmei Li is an associate professor at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Her research interests include epidemiology, cardiovascular disease and biostatistics. Her recent publications appear in Clinical and Experimental Hypertension and Plos One.

Mingzhi Zhang is an associate professor at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Her research interests include epidemiology, cardiovascular disease and biostatistics. Her recent publications appear in Circulation Journal and American Journal of Hypertension.

Aili Wang is a senior experimentalist at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Her research interests include epidemiology, genetic epidemiology and cardiovascular disease. Her recent publications appear in International Journal of Cardiology.

Yonghong Zhang is a professor at the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. His research interests include epidemiology, translation medicine and cardiovascular disease. His recent publications appear in JAMA, Stroke and International Journal of Cardiology.